what social workers *really* need to know about child development

In the final report of her review of child protection, one of Eileen Munro’s recommendations is the development of social workers’ expertise, including an understanding of child development and attachment – in relation to which she cites four texts. In my previous post I suggested that the model of child development presented in these texts is normative, over-emphasizes emotional and social development and has an incomplete frame of reference, for two reasons;

It’s policy-based rather than evidence-based – an evidence-based model would give weight to all factors of child development.

It’s based on biological knowledge that pre-dates WWII. Old knowledge isn’t necessarily wrong, but research has moved on since then. The model of child development proposed by the texts doesn’t seem to recognize this.

In this post I want to focus on the biological aspect; in the next I’ll look at public policy and evidence. In order to explain my reasoning about biological knowledge, I first need to refer to two very different factors that are fundamental to human development; genetics and the idea of constructions of reality.

Genetics

I’ve gone on about genetics quite a bit in this blog; this is partly because genes play a significant role in making us who we are, but also because ideas about how genes work play a significant role in theories of child development. Central to Darwin’s theory about how species changed over time was the concept of natural selection; an organism whose characteristics were suited to any given environment would have a better chance of survival than one whose characteristics weren’t suited to that environment.

Freud graduated in medicine in 1881, the year before Darwin died. Whilst Freud was developing his psychodynamic theory, understanding of the mechanisms that controlled the inheritance of characteristics was changing rapidly. The term ‘genetics’ was coined in 1905, and ‘gene’ in 1910, the same year that genes were found to be located on chromosomes. At the time genes were seen as discrete units of heredity – a bit like beads on a necklace – each responsible for a different inherited characteristic.

A model of genetics frequently used by Freud’s contemporaries assumed that natural selection had produced a genetic blueprint, not just for each individual, but for each species, that resulted in organisms perfectly suited to the environment in which they had evolved. The species blueprint idea implied that all children would follow the same ‘normal’ developmental pathway unless they had a genetic ‘defect’ or there was something wrong with their environment – that there was a normative developmental pathway that children ‘should’ follow.

This model also gave rise to another idea – eugenics. It’s easy to see how the eugenics movement grew out of the concept of a species-specific genetic blueprint; the human population could achieve its potential if genetic ‘defects’ could be eliminated and an ideal environment provided for ‘normal’ children’s natural development. The idea of eugenics arose not so much from inaccuracies in knowledge about genes, but from a misunderstanding (willful in some cases I suspect) of the term ‘survival of the fittest’, coined by Herbert Spencer the Victorian polymath, as a synonym for Darwin’s idea of natural selection. Darwin’s concept was that organisms whose inherited characteristics best suited them to their environment had the best chance of survival. But ‘survival of the fittest’ is often taken to mean ‘might is right’ – which it doesn’t.

structure of DNA


Although DNA (then called ‘nuclein’) had been discovered in the mid-19th century, its structure wasn’t identified until 1953, fourteen years after Freud’s death. Genetic research since the structure of DNA was discovered paints a rather different picture of development. As most people know, DNA has a double-helix structure – like a ladder twisted into a spiral. The rungs of the ladder are made up of pairs of nucleotides – chemical sequences that essentially form templates for the manufacture of the proteins that underpin the structure and function of the body. The nucleotides make up genes, but genes aren’t discrete entities, like beads on a necklace, they consist of sequences of nucleotides. Because of its structure, DNA is susceptible to change when it divides during the formation of sperm or egg cells, and when DNA from each parent recombines after fertilization; single nucleotides – or sequences of nucleotides – can be deleted, duplicated or transposed. Often these tiny changes have no obvious effect, but a variation that results in too much, too little, or the wrong protein being produced at a crucial stage can cause a cascade of events that results in a child’s development being well outside the normal range. The recombination of DNA from each parent and the possibility of spontaneous changes between generations means that each individual is genetically unique (apart from monozygotic twins and their genetic profile isn’t always straightforward). In addition, some environmental (epigenetic) factors can directly affect the expression of genes. Each child’s life experience is also unique. The interaction between a unique genome and a unique environment results in a unique developmental pathway for each child.

Constructions of reality

People have known for a long time that our understanding of the world around us isn’t derived directly from that world, but from our perceptions of it. Because our information about the world is incomplete and our perceptions aren’t entirely reliable we each have a different (sometimes very different) view of reality. Our perceptual filter is also the reason why science deals, not in certainties, but in degrees of uncertainty. The degrees of uncertainty bit is important, because some things are more certain than others. If I jump out of an aircraft flying at 30 000 ft and don’t have a parachute, there’s a high degree of certainty regarding my fate. But there’s little certainty about the identity of the first person I would meet if I were to walk along my street. (The reason for the difference is largely because of the variables involved. There are a small number of well understood variables involved in a body falling from an aircraft, but many unknown variables involved in determining who walks down my road and when.) The idea that we construct our views of reality was given a boost at the end of the 19th century by research into the biological mechanisms of perception; biology backed up something philosophers had been saying for some time.

Genetics, constructions of reality and child development

Someone born in 1856, as Freud was, would probably have been able to keep up-to-date with all new developments in biological research. By the time Freud died in 1939 that would have been challenging. Today it’s impossible. The exponential growth in knowledge has forced disciplines to become increasingly specialised. As a result, there has been an increasing tendency for disciplines to develop their own canon of expertise and an increasing likelihood that the canon won’t be checked against developments in other fields. Clearly, there has always been the risk of someone working in one domain misunderstanding knowledge from another – I might be doing exactly that in relation to social workers’ knowledge of child development since I’m basing my analysis on only four texts – but that risk has increased considerably in the last 100 years. I suggest that it’s increased specialization that’s resulted in the model of child development set out in the four texts, and a failure to check the model against developments in biology that’s resulted in it being normative, over-emphasising emotional and social development and having an incomplete frame of reference.

For example Aldgate et al’s book includes three chapters on child development at different ages; 0-4, 5-11 and 12+. Each chapter is by a different author, but each opens with citations from Freud, Erikson, Piaget and/or Vygotsky. These are important figures in the history of child development research, but it seems strange that chapters written in 2006 should be working from theories proposed almost a century ago that have been called into question by more recent work on developmental processes. The model of child development used by social workers appears to be grounded in attachment theory. But attachment theory is in turn grounded in psychodynamics and psychodynamics in a theory of inherited biological characteristics that has changed significantly since attachment theory was first proposed. (The discrepancy between attachment theory in the social work canon and its scientific grounding is mentioned by Barth et al (2005). Their search of abstracts in the Social Science Citation database of the Institute for Scientific Information yielded almost 1000 references to attachment theory since 1996, but only four scientific evaluations of the theory in the same period.)

I can understand why the model of child development used by social workers focuses on emotional and social aspects but I suggest it’s presented largely in terms of emotional and social aspects for the following reasons:

• By the time the implications of the structure of DNA for child development had become clear, the social sciences already had their own well-established model of child development. It was difficult enough for social scientists to keep up with research in their own field, never mind new ideas in genetics, molecular biology and neuroscience. So the social science model of child development hasn’t taken into account new knowledge from these fields in the post-war period.

• Social scientists and social policy developers have actively avoided incorporating genetic factors into their models of child development because of the legacy of eugenics. Because an over-emphasis on genetic factors had tragic outcomes, and gene therapy is still a new science, a focus on the environment rather than genes has intuitive appeal. But a focus on environment without genes is as problematic as a focus on genes without environment, because human development results from interactions between the two.

• The concept of constructions of reality has had a disproportionate influence on the social sciences. There’s no doubt that people do construct their own realities; it doesn’t follow that reality itself is constructed, nor that each individual’s construction is equally valid, as would become apparent if anyone without a parachute jumped out of an aircraft expecting to float gently to the ground. Models of child development need to take into account the child’s social constructs but child development can’t be framed only in terms of social constructs. Social interaction is often negotiable but the laws of biology aren’t.

I’ve tried to map out this transmission of ideas here:

transmission of ideas about child development

What social workers really need to know…

… about what’s normal

It’s the variation between individuals in genetic make up and its interaction with varied environments that lead to the range of differences seen in the 80% or so of children whose development would be considered normal, and in the 20% or so who, in every generation, fall outside the normal range in some respect.

It’s valid to talk about specific aspects of a child’s development, such as how tall a child is or how many words they can read, being ‘normal’ in a statistical sense (the normal range is anything within two standard deviations from the mean). It’s questionable whether concepts of ‘normal’ are useful in terms of child development as a whole. Although terms like ‘impairment’, ‘abnormal’ or ‘disorder’ are valid in the sense of variation from a specific mean, they’re invalid in the sense of variation from a standard genetic blueprint – which in our case we have not got.

Currently, children’s health, education and social care services are designed to meet the needs of children who are developing normally. They assume a typical developmental pathway to be the norm and something to be aspired to. For some time practitioners working in health, education and social care have not been trained to address the needs of the 20% of children whose development is outside the normal range, a point that has been highlighted in several recent reports. But in order to have the capacity to meet demand, children’s services must be designed to meet the needs of all children. A friend suggested that this hasn’t happened because policy-makers have over-extended the idea of legal and social equality to encompass children’s physical development, and have been unduly influenced by the concept of socially constructed realities. They haven’t take into account genetic variation or its impact on development, quite possibly because it hasn’t featured in their training.

This normative model is especially relevant in the case of children whose developmental atypicalities are framed in behavioural terms, such as those with traits of ASD, ADD, ADHD, PDA etc, particularly those without a formal diagnosis. Genetic profiling is still expensive and isn’t carried out unless behavioural traits are severe or there are obvious physical features involved. Despite biological research indicating that problems with social interaction and attention frequently have physiological origins, anyone unaware of this literature could easily assume that the child has an attachment disorder or has been poorly parented or is a victim of abuse. If that assumption is wrong, it has major implications for the child’s support and consequent development.

Eugenics has cast a long shadow over the Western world; genocide and enforced sterilization have taken place within living memory. Not surprisingly, those engaged in developing social policy since WWII have given genetics a wide berth. It’s now seen as a specialist area of medicine, and social issues are viewed almost exclusively in environmental terms. The eugenics movement saw genes as deterministic in human development and the environment as of minor importance; Freud (and models of child development based on his theories) saw the environment as the determining factor and marginalized the genetic and biological aspects. There is a significant risk in the over-emphasis of either genetic or environmental factors when development is an outcome of interactions between the two. Social workers can’t be expected to be experts on genetics, molecular biology or neuroscience, but using a model of child development based on recent research in those fields rather than on biological knowledge that’s half a century out of date would make sense.

… about developmental pathways

Recent research shows that a child’s developmental pathway is the consequence of the response by the child to a complex series of interactions between his or her biological make up and the environment. Because most children are genetically similar and inhabit similar environments, most follow very similar developmental pathways – so a failure to meet a ‘milestone’ along the typical pathway can indicate that a child’s development might be heading towards a functional problem like impaired speech or mobility. But genetic variations aren’t deviations from a standard human genetic blueprint – because there isn’t one. That means there is no ‘should’ about the ages at which children reach milestones. Indeed, putting pressure on children to achieve certain skills by certain ages might well be counterproductive, since the child could be being pushed in a direction his or her own unique developmental pathway isn’t leading. I’m not suggesting a laissez-faire attitude toward children with developmental trajectories that are atypical, simply that our understanding of development suggests that a functional, rather than normative approach is indicated; what does this child actually need or want to do and how could they best be helped to do it and when?

…about diversity

Ecological research shows clearly that genetic variation enables species to survive environmental change; individuals who don’t adapt to the new conditions either don’t thrive or die. But because human beings are good at figuring out ways of adapting, can communicate and share knowledge and skills, entire communities can withstand change, regardless of the strengths or weaknesses of individuals. Our environment is constantly changing so it’s essential to cultivate the natural diversity of interests, knowledge and skills in populations – exactly the opposite of what a normative model of child development implies. Diversity within communities is extremely important – not because it’s politically correct but because it’s essential for our survival and to safeguard our quality of life. Of course natural variation produces disadvantages as well as advantages. Some children will need significant support and some will behave in ways that cause problems for themselves and others. But we are faced with a stark moral choice in relation to developmental differences – either we accept them as part and parcel of being human and treat every child (as they are, rather than as we want them to be) as a paid-up member of the human race, or we don’t. Each choice has significant consequences for social policy.

Postscript

I contacted Eileen Munro about my concerns. She is currently Chair of the Children’s Faculty of the College of Social Work and is clearly aware of the need to address shortcomings in social workers’ knowledge. So if anyone knows of any material that summarises recent biological research related to child development in a way that’s accessible to non-scientists, she’d like to know about it.

It would be misleading to give the impression that biological factors are entirely absent from these examples of the child development literature. As I’ve mentioned, Aldgate’s book includes a chapter on genetics and biological influences and several chapters that refer to physical development. The Allen report I referred to earlier Early Intervention: The Next Steps and Early Intervention: Good Parents, Great Kids, Better Citizens (Allen & Duncan Smith) each include an entire chapter on brain development, and I plan to review these two chapters later. But next, I want to have a closer look at the model of assessment for children in need proposed by the Department of Health.

Thanks again to those who have contributed to discussions relevant to this post.

References

Aldgate, J., Jones, D., Rose, W. & Jeffrey, C. (eds.) (2006). The Developing World of the Child, London, Jessica Kingsley Publishers.

Barth, R.P, Crea, T.M., John, K, Thoburn, J. & Quinton, D (2005). Beyond attachment theory and therapy: Towards sensitive and evidence-based interventions with foster and adoptive families in distress, Child and Family Social Work, 10, 257–268.

Munro, E. (2011).The Munro Review of Child Protection:Final Report A child-centred system. Department for Education, The Stationery Office.

The book cover is of comedian Elizabeth Beckwith’s 2009 book Raising a Perfect Child through Guilt and Manipulation (Collins Living). Haven’t read it, but I’m probably about to.

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2 thoughts on “what social workers *really* need to know about child development

  1. Intuitive is a word that springs to mind.
    If my reading is correct your concern is the reductionalist assumptions made for the benefit of kids in total leaves carers without adequate knowledge and resources to respond to the needs of those that need it most? Thereby refuting and removing the entire responsibility from bureaucratic society to fulfill its social obligation. And dragging science along kicking and screaming wearing the ugly face of economic rationalism, plastic surgery, what it is to be normal.
    In my way of thinking those that care should be given the most resources regardless of whom or what they care for. Politicians included. And jobs of boring drudgery should be paid the most allowing for a classless socialist responsive questioning society to fulfill itself with a inspired new generation of some different kids.
    That care for each other.

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